Test Bank for Fundamentals of Nursing Active Learning for Collaborative Practice 2nd Edition by Barbara L Yoost | COMPLETE

The nurse is implementing a patient teaching plan regarding diabetes mellitus. One of the short-term goals of the plan is that the patient will be able to verbalize three symptoms of hypoglycemia. The nurse recognizes that this is what type of teaching? a. Psychomotor teaching b. Cognitive teaching c. Affective teaching d. VARK teaching ANS: B Fundamentals of Nursing 2nd Edition Yoost Test Bank NURSINGTB.COM N R I G B.C M Learners in the cognitive domain integrate new knowledge through first learning and then recalling the information. They then categorize and evaluate, making comparisons with previous knowledge that result in conclusions related to the new content. The psychomotor domain incorporates physical movement and the use of motor skills in learning. Teaching the newly diagnosed diabetic how to check blood sugar is an example of a psychomotor skill. Affective domain learning recognizes the emotional component of integrating new knowledge. Successful education in this domain takes into account the patient’s feelings, values, motivations, and attitudes. Tools have been developed to help health care workers evaluate the health literacy of their patients. One such tool is the VARK (verbal, aural, read/write, kinesthetic) assessment of learning styles of people who are having difficulty learning. DIF: Remembering OBJ: 14.4 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education 10. The nurse is working with a diabetic patient and is attempting to teach psychomotor skills. This is occurring when the nurse has the patient complete what action? a. Verbally describe his feelings about diabetes. b. Answer three of five true-or-false questions about diabetes. c. Identify three positive lifestyle changes to manage blood sugar. d. Draw up and self-inject insulin correctly. ANS: D The psychomotor domain incorporates physical movement and the use of motor skills in learning. Teaching the newly diagnosed diabetic how to check blood sugar is an example of a psychomotor skill. Learners in the cognitive domain integrate new knowledge through first learning and then recalling theUinfoSrmaNtionT. TheyOthen categorize and evaluate, making comparisons with previous knowledge that result in conclusions related to the new content. Affective domain learning recognizes the emotional component of integrating new knowledge. Successful education in this domain takes into account the patient’s feelings, values, motivations, and attitudes. DIF: Applying OBJ: 14.4 TOP: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education 11. The nurse is preparing to teach a patient for the first time and needs to evaluate the health literacy of the patient. The nurse uses the VARK assessment to gather what information? a. Assess the learning styles of the patient. b. Find the one method that the patient uses to learn. c. Be sure that the patient is a unimodal learner. d. Reduce the need for creating a collaborative learning plan. ANS: A Fundamentals of Nursing 2nd Edition Yoost Test Bank NURSINGTB.COM N R I G B.C M Tools have been developed to help health care workers evaluate the health literacy of their patients. One such tool is the VARK (verbal, aural, read/write, kinesthetic) assessment of learning styles of people who are having difficulty learning. Individuals typically learn through more than one method. For example, a patient’s VARK assessment may indicate learning through VAR or ARK. When the use of more than one style facilitates learning, the individual is considered a multimodal learner, meaning that the person does best when more than one teaching strategy is used or that the person is able to adapt to a variety of teaching strategies on the basis of what is being presented. Understanding how patients learn best makes collaborative learning plans most effective. It is good practice to provide multiple means of learning, because most individuals learn through more than one style and repetition enhances learning. DIF: Applying OBJ: 14.5 TOP: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education 12. The nurse is preparing to teach a 90-year-old patient. In teaching an elderly patient, the nurse realizes what information? a. Most elderly patients are highly literate. b. Cognitive abilities always decline with age. c. Sensory alterations often occur with aging. d. Teaching methods are the same as for the middle aged. ANS: C Teaching should be tailored to elderly patients. Reports indicate that two-thirds of U.S. adults 66 years old and older have inadequate or marginal literacy skills, and 81% of patients 60 years old and older at a public hospital could not read or understand basic materials such as prescription labels. Although eUachSpatiNentTmust asOsessed individually, cognitive and sensory alterations often occur with aging, and the teaching materials should be adjusted accordingly. DIF: Understanding OBJ: 14.6 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education 13. The nurse identifies which patient would most likely need to have adjustments made to the education plan for discharge because of role function? a. A 67-year-old married female who lives with her retired husband b. A 32-year-old single mother of a toddler following hysterectomy c. A 13-year-old who lives at home with his parents after appendectomy d. A 50-year-old married mother with two children in college and teenager at home ANS: B Exploration of the patient’s roles is an important task that must be done before development of a patient education plan. For example, a 32-year-old, single mother of five young children who has just undergone a hysterectomy may require a different perspective in her discharge instructions than that in the instructions of a 67-year-old female living with her husband who recently retired after 35 years as a family practice physician. The first patient may have less support and less flexibility regarding rest, lifting limitations, and cost of prescriptions than the second. It is important not to stereotype and assign roles but rather to develop a plan in collaboration with the individual. The patient’s support system should be taken into consideration when the nurse plans patient education. Fundamentals of Nursing 2nd Edition Yoost Test Bank NURSINGTB.COM DIF: Evaluating OBJ: 14.6 TOP: Evaluation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education 14. When the nurse is preparing to provide preoperative teaching to a deaf patient, what action by the nurse is best? a. Use printed materials. b. Provide recorded materials. c. Use a family member to interpret. d. Provide an interpreter. ANS: D Patients who are deaf or have low English proficiency are entitled to professional interpretation by federal law. Printed material may be helpful but not if the patient has low literacy/low health literacy. Recorded material may be an option is the patient has some hearing and the recordings are amplified. Family members are not used as interpreters. DIF: Applying OBJ: 14.7 TOP: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education 15. When the nurse is preparing to teach a 5-year-old child postoperative care that will be anticipated after a tonsillectomy, the nurse would incorporate what concept? a. Use pictures and simple words to describe care to the patient. b. Teach the parents alone to reduce fear in the patient. c. Exclude the parents to reduce parental anxiety. d. Use clear simple explanaNtioUnRs StoIcoNnGveTyBin.fCorOmMation. ANS: A Patient education provided for children should be age specific. Use pictures and simple words for young children. Use clear, simple explanations for school-age children. The patient’s age directly affects the instructional methods and materials used. Effective patient education involving a child requires the presence of a parent or caregiver, who is likely the target of teaching. Children should not be excluded from the learning session unless exclusion is deemed appropriate by the parent or caregiver; a presentation using an age-appropriate strategy may complement the instructions reviewed with the adult. The stages of development should be explored as the foundation for the choice of educational materials. DIF: Applying OBJ: 14.7 TOP: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education 16. The nurse is preparing a teaching plan and is applying evidence-based practice. To promote involvement, the nurse must include which concept? a. Provide the latest professional literature to the patient. b. Ensure that the patient understands relevant information. c. Use only one teaching method to reduce confusion. d. Not review previously learned information. ANS: B Fundamentals of Nursing 2nd Edition Yoost Test Bank NURSINGTB.COM To promote involvement, nurses must ensure that patients understand the information relevant to their care. Nurses need to provide patients with easy-to-understand information and speak in a clear, distinct voice, using short sentences and understandable terminology. Multiple teaching methods should be used to meet the needs of all types of learners. Patient education sessions should be reassessed after two to three key points to ensure that the patient is still engaged in learning and ready to assimilate more information. Information taught at previous sessions can be reviewed before proceeding with new key points. DIF: Applying OBJ: 14.7 TOP: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education 17. In determining patient goals, the nurse should complete which action? a. Allow patients to identify what is most important to them. b. Take the lead and determine what is best for the patient. c. Focus on health promotion and staying healthy. d. Explain the importance of avoiding complications. ANS: A As health care educators, nurses should allow patients to identify what is most important to them. If a newly diagnosed diabetic patient is interested in learning techniques of care that will allow discharge to home rather than to an extended care facility, the patient is more likely to be receptive to learning about self-monitoring blood sugar levels. After the learning goals related to the issues that the patient feels are a priority have been met, the patient may then be able to focus on health promotion and avoiding complications. DIF: Applying OBJ: 14.9 TOP: Implementation MSC: NCLEX Client Needs CNateUgRorSy:IHNeaGltTh PBCoOtioMn and Maintenance NOT: Concepts: Patient Education 18. The nurse understands ongoing evaluation of patient education occurs by which team member? a. Each member of the health care team who provides teaching b. The nurse who evaluates the patient’s physical abilities c. The patient stating that he understands the instruction d. Not allowing review from the provider so the focus remains forward ANS: A Ongoing evaluation of patient education occurs by each member of the health care team who provides teaching according to the patient’s teaching plan. Having the learner repeat what has been learned can help the nurse evaluate the teaching plan and adjust the plan for future patient education sessions. Future sessions should review what was learned previously and continue to add to what has been taught. Health care team members can view documentation on the electronic health record (EHR) before beginning an education session to determine the patient’s progress in meeting educational goals. DIF: Understanding OBJ: 14.10 TOP: Evaluation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education MULTIPLE RESPONSE Fundamentals of Nursing 2nd Edition Yoost Test Bank NURSINGTB.COM N R I G B.C M 1. In addressing patient education, the nurse recognizes that patient education is a process involving what components? (Select all that apply.) a. Assessment b. Diagnosis c. Planning d. Implementation and evaluation e. Reliance on evidence-based practice (EBP) ANS: A, B, C, D Assessment of health literacy occurs with each patient encounter. On completion of assessment, a nursing diagnosis relevant to the educational needs of the patient or caregiver can be determined. After working with the patient or caregiver to determine the appropriate nursing diagnosis, the next step is developing the patient education plan. In all patient education situations, a return demonstration by the patient (i.e., repeating what has been taught) helps the nurse to assess the level of learning that has taken place. Although evidence-based practice is important, it is sometimes insufficient when making patient care decisions. DIF: Understanding OBJ: 14.2 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education 2. According to the Healthy People 2020 initiative, health information and the associated access issues have become more complicated. There are many considerations when determining whether an individual has proficient health literacy. The nurse acknowledges that the patient should be able to do what actions? (Select all that apply.) a. Read and identify credible UheaSlth iNnforTmationO. b. Recognize abnormalities on an x-ray. c. Navigate complex insurance programs. d. Evaluate EKG findings. e. Advocate for appropriate care. ANS: A, C, E The patient should be able to exhibit certain competencies such as reading and identifying credible health information, understanding numbers in the context of the patient’s health care, making appointments, filling out forms, gathering health records and asking appropriate questions of physicians, advocating for appropriate care, navigating complex insurance programs (Medicare or Medicaid, and other financial assistance programs), and using technology to access information and services. Interpreting EKGs and X-rays is beyond this scope. DIF: Applying OBJ: 14.2 TOP: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education 3. In preparing to teach the patient, the nurse must consider which concepts? (Select all that apply.) a. Background b. Race c. Pain level Fundamentals of Nursing 2nd Edition Yoost Test Bank NURSINGTB.COM U S N T O d. Emotional status e. Readiness to learn ANS: A, C, D, E Consideration must be given to the patient’s background, readiness to learn, and current condition before education can occur. A patient’s ability to read, write, and comprehend health care materials enhances health literacy. Race, by itself, is not a factor. DIF: Applying OBJ: 14.3 TOP: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education 4. The nurse is to teach an 84-year-old Spanish-speaking patient newly diagnosed with diabetes how to self-administer insulin. The patient has hearing and visual impairments. To be effective as a teacher, the nurse should carry out which tasks? (Select all that apply.) a. Assess reading level and learning style. b. Determine readiness to learn. c. Use family members as interpreters. d. Provide written instruction in English. e. Place the patient in group classes. ANS: A, B Before health care teaching sessions for adults, assess reading level, learning styles, and readiness to learn. Family members should not be used as interpreters of specific medical information to maintain the patient’s right to privacy and to avoid possible misinterpretation of medical terminology. Access to interpretation or translation for deaf and limited English proficiency (LEP) patients is required by Title VI of the Civil Rights Act of 1964, which mandates equal rights for peoNpleRregIardlGessBof.rCace,Mcolor, or national origin. Use photos, drawings, or video to enhance understanding. A patient whose cultural beliefs and values are considered is more likely to demonstrate compliance. Patients with learning disabilities or cognitive alterations need individualized instruction geared to their special needs. DIF: Applying OBJ: 14.6 TOP: Implementation MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education 5. When teaching children, the nurse should include which concepts? (Select all that apply.) a. Exclude the children from teaching. b. Encourage parents or caregivers to be present. c. Use age-specific strategies. d. Consider the stages of development. e. Remember that parents are not the targets of the teaching. ANS: B, C, D Patient education provided for children should be age specific. Effective patient education involving a child requires the presence of a parent or caregiver, who is likely the target of teaching. Children should not be excluded from the learning session unless exclusion is deemed appropriate by the parent or caregiver; a presentation using an age-appropriate strategy may complement the instructions reviewed with the adult. The stages of development should be explored as the foundation for the choice of educational materials. DIF: Applying OBJ: 14.6 TOP: Implementation Fundamentals of Nursing 2nd Edition Yoost Test Bank NURSINGTB.COM MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education 6. The nurse must provide patient education to a patient who has just been given the diagnosis of stage III cancer. The patient is complaining of chest and bone discomfort. Before providing the needed education, the nurse will complete which tasks? (Select all that apply.) a. Draw the curtain in the semi-private room. b. Medicate the patient to ease the pain. c. Place the patient in a private room if possible. d. Wait until later in the day. e. Attend to any other personal needs first. ANS: B, C, D, E The location of patient education influences the outcome. The setting should be quiet, and the session should have minimal interruptions. Providing privacy is difficult in settings such as emergency rooms, outpatient surgery centers, and semi-private inpatient rooms, but the nurse should make every effort to ensure confidentiality. Environmental considerations such as good lighting and the availability of resources should be explored to enhance the outcome of patient education. The nurse should examine the patient’s situation and comfort level before beginning teaching. For example, a postoperative patient who is rating pain at 7 of 10 will be much more receptive to learning after being medicated for pain. A patient who just received a diagnosis of metastatic cancer will learn and assimilate more information later in the day or perhaps the next day. The nurse must also take care of any other personal needs first, such as the need to use the bathroom. DIF: Applying OBJ: 14.7 TOP: Implementation MSC: NCLEX Client Needs CN ategR ory:I HeaG lth PB r . omC otioM n and Maintenance NOT: Concepts: Patient EducatioUn S N T O 7. On completion of assessment, a nursing diagnosis relevant to the educational needs of the patient or caregiver can be determined. The nurse recognizes that diagnoses specifically related to patient education include which responses? (Select all that apply.) a. Deficient knowledge b. Readiness for enhanced knowledge c. Noncompliance d. Pain e. Alteration in elimination ANS: A, B, C On completion of assessment, a nursing diagnosis relevant to the educational needs of the patient or caregiver can be determined. Diagnoses specifically related to patient education include deficient knowledge, readiness for enhanced knowledge, and noncompliance. DIF: Remembering OBJ: 14.8 TOP: Assessment MSC: NCLEX Client Needs Category: Health Promotion and Maintenance NOT: Concepts: Patient Education Chapter 15: Nursing Informatics MULTIPLE CHOICE 1. The integration of nursing, computers, and information science for the management and communication of data, information, knowledge, and wisdom is: a. nursing informatics. b. computer science. c. medical informatics. d. informatics. ANS: A Informatics is a broad academic field encompassing artificial intelligence, cognitive science, computer science, information science, and social science. Medical informatics refers to informatics related to health care and describes a distinct specialty in the discipline of medicine. Nursing informatics is a specialty area of informatics that addresses the use of health information systems to support nursing practice. The American Nurses Association (ANA, 2008) states that the specialty of nursing informatics integrates nursing computer and information science for the management and communication of data, information, knowledge, and wisdom. DIF: Remembering REF: p. 206 OBJ: 15.1 TOP: Assessment MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care NOT: Concepts: Technology and Informatics 2. The hospital has recently implemented computer charting. The computerization of nursing practice: a. enhances and increases the time spent on documentation. b. makes patient data immediately available to the health care team. c. makes retrieval of data more difficult but safer. d. is enhanced by limiting the use of point-of-care technology. ANS: B Patient data collected by a nurse and recorded electronically are immediately available to all members of the health care team. The computerization of nursing practice data enables capture, storage, retrieval, organization, processing, and analysis of information. The information can be used to make a diagnosis, plan for care, provide nursing decision support, enhance documentation, and identify nursing care trends and costs. Systems that support data collection at the point of care can directly enhance patient care by decreasing the time spent on documentation, reducing the potential for errors, and supporting improved assessment and data communication. Computers, tablets, or pocket devices used at the bedside for documentation are examples of point-of-care technology. DIF: Understanding REF: p. 206 OBJ: 15.1 TOP: Assessment MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care NOT: Concepts: Technology and Informatics 3. Nurses working surrounded by computers and mobile IT must develop skills in the use of all available technology. At the same time, it is important to recognize that: a. the technology in use today will be the same tomorrow. b. cell phones are not usually allowed in the acute care setting. c. most forms of mobile technology are in violation of HIPAA guidelines. d. the technology supports bedside and remote charting. ANS: D Nurses working surrounded by computers and mobile IT must develop skills in the use of all available technology. At the same time, it is important to recognize that the rapid advancement of IT means that the technology in use today may be entirely different tomorrow. Some facilities have computer access at every bedside, and others have mobile computers, sometimes called workstations on wheels (WOWs), that can be taken to each bedside. Nurses using technology as part of patient care need to work within facility policy and HIPAA guidelines. The technology supports bedside and remote charting. Nurses may use a portable device such as a smartphone or tablet computer to access reference materials, including medical information and vast amounts of drug information. Some facilities issue these devices to staff. DIF: Understanding REF: pp. 206-207 OBJ: 15.2 TOP: Assessment MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care NOT: Concepts: Technology and Informatics 4. The home health nurse provides care for a patient with congestive heart failure. Daily the patient weighs himself and takes his own temperature, pulse, respirations and blood pressure. That information is sent as electronic data to the patient’s physician and nurse daily to make adjustments to the plan of care as indicated. This is an example of: a. telehealth nursing. b. computerized decision support system (DSS). c. computerized provider order entry (CPOE). d. point of care technology. ANS: A Telehealth nursing is the transmission by a nurse of electronic data, images, or audio from a patient’s bedside or home to other health providers for the purpose of providing care and improving outcomes. Patients may have telehealth hardware in their homes to provide inhome monitoring and direct reporting to their health care providers. Computerized decision support systems (DSSs) include safe practice alerts and reminders that improve the quality of care. Some DSSs assist in determining a correct diagnosis and choosing an appropriate medication. Computerized provider order entry (CPOE) allows orders to be directly communicated to the appropriate department—diet orders to dietary, medication orders to the pharmacy, laboratory orders to the laboratory. Computers, tablets, or pocket devices used at the bedside for documentation are examples of point-of-care technology. Patient data collected by a nurse and recorded electronically are immediately available to all members of the health care team. DIF: Understanding REF: pp. 206-207 OBJ: 15.2 TOP: Assessment MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care NOT: Concepts: Technology and Informatics 5. Information technology (IT) can be used to increase patient safety. The nurse uses IT in this way by: a. creating redundancy in orders making them safer. b. removing the need for verification by the nurse. c. analyzing errors to develop prevention strategies. d. eliminating the need for bar codes in medication administration. ANS: C IT can be used to increase patient safety. Errors are analyzed to develop strategies for prevention. Diagnostic test results are available faster to support treatment decisions and avoid redundancy in orders. When technology such as a bar-code medication administration (BCMA) system is used as part of the process of medication administration, fewer errors are made. After signing into the system or scanning his/her identification (ID) badge, the nurse electronically scans the bar codes of the patient ID, the medication administration record (MAR), and the drug to determine that the right patient is getting the right drug and dose at the right time. An alert signals a potential error, and it is the nurse’s responsibility to verify all information before administration. DIF: Applying REF: p. 208 OBJ: 15.3 TOP: Implementation MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care NOT: Concepts: Technology and Informatics 6. When technology such as a bar-code medication administration (BCMA) system is used as part of the process of medication administration, fewer errors are made. The proper procedure when using the BCMA includes: a. signing into the system using the patient’s ID number. b. typing in the patient’s name and room number. c. scanning the patient’s ID, MAR, and medication. d. discontinuing the medication if the system signals an error. ANS: C When technology such as a BCMA system is used as part of the process of medication administration, fewer errors are made. After signing into the system or scanning his/her ID badge, the nurse electronically scans the bar codes of the patient ID, the MAR, and the drug to determine that the right patient is getting the right drug and dose at the right time. An alert signals a potential error, and it is the nurse’s responsibility to verify all information before administration. DIF: Applying REF: p. 208 OBJ: 15.3 TOP: Implementation MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care NOT: Concepts: Technology and Informatics 7. Computerized provider order entry (CPOE) allows orders to be directly communicated to the appropriate department. Other advantages of CPOE include: a. decrease in number of transcribing errors. b. enhanced provider acceptance because of new technology. c. decreased work flow issues in general. d. less dependence on technology and computers. ANS: A Computerized provider order entry (CPOE) allows orders to be directly communicated to the appropriate department. CPOE systems ensure legible orders and have the potential to reduce ordering and transcribing errors. Disadvantages of CPOE include workflow issues, provider resistance to new technology, and overdependence on technology (AHRQ, 2012). DIF: Understanding REF: p. 208 OBJ: 15.3 TOP: Assessment MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care NOT: Concepts: Technology and Informatics 8. When using electronic medical records (EMR), the nurse knows that the EMR: a. holds the documentation of a single episode of care. b. is a longitudinal record of care for each patient. c. is widely used for individual health care encounters. d. includes progress notes for all disciplines. ANS: A The electronic medical record (EMR), which is the documentation of a single episode of care (i.e., outpatient visit or inpatient stay), becomes a part of the electronic health record (EHR), which is a longitudinal record of care. EHRs are becoming widely used for individual health care encounters and for maintaining patients’ health records over long periods. As EHRs become fully implemented, they include provider order entries, progress notes for all disciplines, computerized medication profiles, access to diagnostic test results on a timely basis, decision support systems, and online clinical reminders and alerts. DIF: Understanding REF: p. 209 OBJ: 15.3 TOP: Assessment MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care NOT: Concepts: Technology and Informatics 9. Computerized provider order entry (CPOE): a. allows orders to be communicated to the appropriate department. b. creates an intermediary for order transcription. c. slows documentation and provider communication. d. may lead to increased ordering and transcription errors. ANS: A Computerized provider order entry (CPOE) allows orders to be directly communicated to the appropriate department—diet orders to dietary, medication orders to the pharmacy, laboratory orders to the laboratory. Elimination of an intermediary for order transcription decreases the potential for errors related to the ambiguity of handwritten orders and allows quicker responses by appropriate departments. Legibility and availability of computerized documentation improve provider communication. The Agency for Healthcare Research and Quality (AHRQ) recommends CPOE as one of the safe practices for better health care. CPOE systems ensure legible orders and have the potential to reduce ordering and transcribing errors. Disadvantages of CPOE include workflow issues, provider resistance to new technology, and overdependence on technology (AHRQ, 2012). DIF: Understanding REF: p. 208 OBJ: 15.3 TOP: Assessment MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care NOT: Concepts: Technology and Informatics 10. The nurse is providing care to a patient newly diagnosed with multiple sclerosis. The patient expresses the desire to communicate with other people living with the disorder. The nurse appropriately refers the patient to: a. an e-mail list with the patient’s contacts. b. a social media blog. c. a listserv concerning multiple sclerosis. d. Facebook, Twitter, and LinkedIn. ANS: C Listservs can be used in health care to connect groups of patients with common problems or to send updated information to large groups. E-mail has become a common means of communication but would not be focused on the patient’s issues. Social media include online technologies such as Facebook, Twitter, and LinkedIn that allow people to communicate easily by the Internet to share information and resources, but they are more general than listservs. These technologies enable a potentially massive community of participants to collaborate, providing a mechanism for tapping into collective power in ways previously unachievable. A blog is a social medium that is usually maintained by an individual and has regular entries of commentary, descriptions of events, or other material such as graphics or videos. Most blogs are interactive, allowing visitors to leave comments and message each other. Many blogs focus on health care issues. DIF: Understanding REF: p. 209 OBJ: 15.3 TOP: Assessment MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care NOT: Concepts: Technology and Informatics 11. The nurse can see data relationships, can make judgments based on trends and patterns in the data, is skilled in information management and the use of computer technology, and is able to suggest areas for IT system improvement. The nurse’s level of informatics competency can be described as: a. beginner. b. experienced. c. specialist. d. innovator. ANS: B Descriptions of nursing informatics competencies often focus on levels that include beginner, experienced, specialist, and innovator. Beginner skills include computer, information, and web literacy; fundamental skills in information management and computer technology; and the ability to identify and collect relevant data. The nurse at the beginning level may have keyboarding skills, can document in the EHR, and look up medications and other health information on reputable Internet reference sites. The nurse at the experienced level of informatics competencies is able to see data relationships and make judgments based on trends and patterns in data, is skilled in information management and the use of computer technology, and is able to suggest areas for IT system improvement. The nurse at the specialist level of competency focuses on information needs for the practice of nursing; integrates and applies information science, computer science, and nursing science; and applies skills in critical thinking, data management, processing, and system development. At the specialist level of competency, the nurse may conduct research based on information trends or patient data, devise applications for computer technology in nursing, or develop new software to enhance nursing care. Nursing informatics innovators conduct research and generate theory. They develop solutions and understand the interdependence of systems, disciplines, and outcomes. DIF: Analyzing REF: p. 209 | p. 211 OBJ: 15.4 TOP: Evaluation MSC: NCLEX Client Needs Category: Safe and Effective Care Environment: Management of Care NOT: Concepts: Technology and Informatics 12. The director of nursing on a medical–surgical floor has met education and experience requirements in nursing informatics. The nurse might expect administration to request that he/she pursue: a. technical competencies. b. utility competencies. c. certification from ANCC. d. leadership competencies. ANS: C After meeting the educational and experience requirements, the nurse can receive certification in nursing informatics from the Health Care Information and Management Systems Society (HIMSS) and through the American Nurses Credentialing Center (ANCC). Technical competencies pertain to the use of computers and other technological equipment and the use of a variety of software programs for word processing, spreadsheet and database development, presentation, referencing, and e-mail. Utility competencies address critical thinking and evidence-based practice applications. Nurses who have a utility competency recognize the relevance of nursing data for improving practice and can access multiple information sources for gathering evidence for clinical decision making. Leadership competencies address the ethical and management issues related to using IT in nursing practice, education, research, and administration. Specific leadership competencies include the application of accountability, maintenance of privacy and confidentiality, and quality assurance. Technical, utility, and leadership competencies c